Neurobehavioral effects of occupational exposure to low-level organic solvents among Taiwanese workers in paint factories.

At six paint factories in northern Taiwan, 325 workers participated in a detailed evaluation that included medical and occupational questionnaires, blood sampling, neurobehavioral tests, vibratory perception threshold tests, and thermal perception threshold tests. Because of cultural differences, a Chinese test battery was modified from the Neurobehavioral Evaluation System 2. Eleven tests were performed: finger tapping, continuous performance, associated learning, symbol-digit, pattern comparison, pattern memory, visual digit span, switch attention, associated delayed recognition, mood scales, and vocabulary. Air concentrations of organic solvents were measured by passive personal samplers and analyzed by gas chromatography. Results showed that major solvents to which the workers were exposed were toluene, xylene, n-hexane, methyl iso-butyl ketone, and n-butyl acetate. The exposure index (EI) was classified by different exposure patterns and different air concentrations in the breathing zone as follows: EI 0, nonexposure; EI 1, low exposure; and EI 2, high exposure (the medians of 8-hr hygienic effects were 0, 0.03, and 0.25, respectively). Because of their diverse socioeconomic status and demographic characteristics, the workers were divided into two groups for additional analysis: one group comprised white-collar workers, including technicians and administrative staff, and the other comprised blue-collar workers. By using multiple linear regression analysis controls for age, sex, education, and alcohol intake, significant associations were found between increased exposure to solvent mixtures and performance on some neuropsychologic tests. In the blue-collar group, significantly prolonged response latencies were observed in the tests of continuous performance, pattern comparison, and pattern memory. Among white-collar workers, significant impairment was observed in the continuous performance test. All three tests involved visual attention and perceptual (speed and memory) functions. It was concluded that these may be the earliest neurotoxic signs of occupational exposure to low-level organic solvents in paint manufacturing workers.